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Vaccines alone won’t stop malaria

US Army medical researchers administer malaria vaccines as part of World Malaria Day in Kenya in 2010. US Army Southern European Task Force, Africa/Flickr
US Army medical researchers administer malaria vaccines as part of World Malaria Day in Kenya in 2010. US Army Southern European Task Force, Africa/Flickr

After 30 years of research, there are now two malaria vaccines.

One, R21/Matrix-M, was approved for use in Ghana and Nigeria in April this year. It was developed by Oxford University scientists and manufactured by the Serum Institute of India and follows the first publicly available malaria jab – RTS,S – which was endorsed by the World Health Organization (WHO) in 2021.

Growing up in rural Uganda, where malaria was and still is endemic, the disease was a regular deadly visitor. There were countless nights of excruciating fever and it was common to find more than three children from the same family infected with it. Many school days were missed and we lost some friends and family.

With the nearest hospital more than 30 kilometres away, families were constantly doing a balancing act between local remedies and cheaper drugs from local stores in order to avoid expensive hospital stays.

Worldwide, 619,000 malaria deaths were registered in 2021. Africa had 95 per cent of malaria cases and 96 per cent of malaria deaths – the overwhelming majority children. All this despite the fact that malaria is preventable and curable.

The vaccine, if equitable access is guaranteed, will have a major impact on the cost of healthcare and the livelihoods of households. But the fact that vaccines exist, as we have seen with Covid-19, doesn’t necessarily translate into everyone being able to access them.

Without adequate and consistent public funding and sharing of technology, many in low-income countries will remain marginalized, facing public health threats that the rest of the world considers dealt with. Racial, ethnic, geographical and socioeconomic inequities not only impact health outcomes and wellbeing, but they determine who gets treated with the necessary urgency.

For instance, while the WHO set a goal to fully vaccinate 70 per cent of people in all countries against Covid-19 by mid-2022, in early May 2023 when it declared the global health emergency over many in the Majority World remained unvaccinated. While the estimated wastage rate for Covid-19 vaccines is reported to be up to 30 per cent, in May public health agency Africa CDC reported that just 52 per cent of the continent’s population was fully vaccinated.

Ensuring equitable access depends on addressing the key weaknesses in global public health systems that the pandemic glaringly exposed. Public health infrastructure improvements are urgently needed which calls for long-term public investment commitments.

Vaccine hesitancy is also a major issue in the region, thanks to mis/disinformation, anti-vaccine propaganda and the militarized responses to the pandemic that in some countries eroded public trust.

The vaccine science and technology may be here, but these developments have often taken a long time to reach those on the margins. Here’s hoping it doesn’t take another 30 years to end malaria.

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